This publication presents the Agenda for the Americas on Health, Environment, and Climate Change 2021–2030 (the Agenda). The Agenda is a call to action to the health sector to lead the charge to address environmental determinants of health in the Americas. The Pan American Health Organization (PAH...O) will work with Member States to achieve its goal and objective to ensure healthy lives and promote well-being for all at all ages using a sustainable and equitable approach that places a priority on reducing health inequity. The Agenda has been developed under the umbrella of the WHO Global Strategy on Health, Environment, and Climate Change, and builds upon the commitments set forth in the Sustainable Health Agenda for the Americas 2018–2030 and the PAHO Strategic Plan 2020–2025. The Agenda was developed in consultation with the Technical Advisory Group and through a consensus-driven decision-making process with Member States during the 2019–2020 period. Looking toward the achievement of Sustainable Development Goal 3, the Agenda focuses on: improving the performance of environmental public health programs and institutions; fostering environmentally resilient and sustainable health systems; and promoting environmentally healthy and resilient cities and communities. Its implementation will be context-specific, based on the needs and realities of the countries. It will benefit countries and territories by promoting good governance practices, strengthening the leadership and coordination roles of the health sector, fostering cross-sectoral action, focusing on primary prevention, and enhancing evidence and communication. It will facilitate access to human, technical, and financial resources necessary to address environmental determinants of health and ensure that the Region is fully engaged in global health, environment, and climate change processes and agreements. The objective of the Agenda is to strengthen the capacity of health actors in the health and non-health sectors to address and adapt to environmental determinants of health (EDHs), prioritizing populations living in conditions of vulnerability, in order to meet Outcome 18 of the PAHO Strategic Plan 2020–2025 directly and several other outcomes of the Plan indirectly. To address and adapt to the challenges of EDHs in the Region, an integrated and evidence-informed approach within the health sector and across sectors will be needed, one enabled, and supported by good governance practices, adequate management mechanisms, high-level political will, and adequate human, technical, technological, and financial resources.
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The COVID-19 Strategic Preparedness and Response Plan (SPRP) 2021 Monitoring and Evaluation Framework tracks global progress against the COVID-19 SPRP 2021 for the ten pillars of the public health response. The operational intelligence complements the epidemiologic information used to drive a global... dynamic system of support and response. Monitoring SPRP 2021 implementation will support countries, partners and WHO in strategic thinking, operational tracking and course correction based on evidence and transparency to strengthen the response to COVID-19.
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UNFPA has been implementing programming for women and girls through Women Friendly Health Spaces (WFHSs), which provide access to critical services, information and support. The WFHS is providing: psychosocial counseling services; awareness raising sessions on PSS in the community; and life skills &... vocational training opportunities. The WFHS also facilitates referral to other services including Psychosocial Counseling Centers (PSCCs).
The aim of this guidance note is to provide an overview of approaches on how to successfully integrate adolescent and youth (A&Y) programming into the WFHSs. UNFPA activities for women’s and girl’s protection in health facilities aim to protect women and girls including child marriage. Given that vulnerable women and girls in Afghanistan continue to access health facilities, particularly for reproductive health and maternal health services, it is crucial to provide support for survivors in the same location to improve access to essential psychosocial and protection support for women and girls. To support the integration of A&Y in the WFHS programming each WFHS will be supported by two full time Youth Educators. A female Youth Educator who will be working within the WFHS and a male Youth Educator who will be working in the community. The role of the Youth educators is to increase A&Y awareness and knowledge on living healthy lifestyles and ensuring a referral system to services in existing facilities.
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Hendra virus (HeV) continues to pose a serious public health concern as spillover events occur sporadically. Terminally ill horses can exhibit a range of clinical signs including frothy nasal discharge, ataxia or forebrain signs. Early signs, if detected, can include depression, inappetence, colic o...r mild respiratory signs. All unvaccinated ill horses in areas where flying foxes exist, may potentially be infected with HeV, posing a significant risk to the veterinary community. Equivac® HeV vaccine has been fully registered in Australia since 2015 (and under an Australian Pesticides and Veterinary Medicines Authority special permit since 2012) for immunization of horses against HeV and is the most effective and direct solution to prevent disease transmission to horses and protect humans. No HeV vaccinated horse has tested positive for HeV infection. There is no registered vaccine to prevent, or therapeutics to treat, HeV infection in humans. Previous equine HeV outbreaks tended to cluster in winter overlapping with the foaling season (August to December), when veterinarians and horse owners have frequent close contact with horses and their bodily fluids, increasing the chance of zoonotic disease transmission. The most southerly case was detected in 2019 in the Upper Hunter region in New South Wales, which is Australia's Thoroughbred horse breeding capital. Future spillover events are predicted to move further south and inland in Queensland and New South Wales, aligning with the moving distribution of the main reservoir hosts. Here we (1) review HeV epidemiology and climate change predicted infection dynamics, (2) present a biosecurity protocol for veterinary clinics and hospitals to adopt, and (3) describe diagnostic tests currently available and those under development. Major knowledge and research gaps have been identified, including evaluation of vaccine efficacy in foals to assess current vaccination protocol recommendations.
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Developed as part of the UN Women–WHO Global Joint Programme on Violence Against Women Data, this briefing note focuses on the measurement of violence against women with disability and is one in a series of methodological briefing notes for strengthening the measurement and data collection of viol...ence against particular groups of women or specific aspects of violence against women.
The briefing note is meant for researchers, national statistics offices, and others involved in data collection on violence against women. It provides an overview of the challenges in the availability, measurement, and collection of data on violence against women with disability and outlines recommendations for good practice in measurement, with the aim of strengthening ongoing and future data collection efforts and increasing the availability of such data.
The inclusion of women with disability and the issue of disability within population-based surveys and research on violence against women is necessary for an improved understanding of populations of women at specific risk of violence. This knowledge would also allow more tailored prevention strategies and response/services and programmes to be designed in a way that addresses the specific needs of women with disability.
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The Cartagena Declaration on Refugees was adopted by the Colloquium on the International Protection of Refugees in Central America, Mexico and Panama on November 22, 1984. The declaration is a non-binding agreement but has been incorporated in refugee law in various countries. The Cartagena Declarat...ion on Refugees bases its principles on the “commitments with regards to refugees” defined in the Contadora Act on Peace and Cooperation (which are based on the 1951 UN Refugee Convention and the 1967 Protocol).
It includes a range of detailed commitments to peace, democratization, regional security and economic co-operation. It also provided for regional committees to evaluate and verify compliance with these commitments.
This document contains the Spanish, French and English versions of the original text.
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The Multi-professional Patient Safety Curriculum Guide (2011) was developed to assist in the teaching of patient safety in universities and schools in the fields of dentistry, medicine, midwifery, nursing and pharmacy. It also supports the on-going training of all health care professionals.
The C...urriculum Guide is comprised of two parts. Part A is a teachers’ guide designed to introduce patient safety concepts to educators. It relates to building capacity for patient safety education, programme planning and design of the courses. Part B provides all-inclusive, ready-to-teach, topic-based patient safety courses that can be used as a whole, or on a per topic basis. There are 11 patient safety topics, each designed to feature a variety of ideas and methods for patient safety learning. Universities are encouraged to start with Part A which provides comprehensive advice on how to introduce and build patient safety courses.
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The discourse on climate change and migration has shifted from labelling migration merely as a consequence of climate impacts, to describing it as a form of human adaptation. This article explores the adaptation framing of the climate change and migration nexus and highlights its shortcomings and ad...vantages. While for some groups, under certain circumstances migration can be an effective form of adaptation, for others it leads to increased vulnerabilities and a poverty spiral, reducing their adaptive apacities. Non-economic losses connected to a change of place further challenge the notion of successful adaptation. Even when migration improves the situation of a household, it may conceal the lack of action on climate change adaptation from national governments or the international community. Given the growing body of evidence on the diverse circumstances and outcomes of migration
in the context of climate change, we distinguish between reactive and proactive migration and argue for a precise differentiation in the academic debate
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Financing Global Health 2013: Transition in an Age of Austerity, IHME’s fifth annual report on global health expenditure, depicts financing trends that underline the resilience of development assistance for health. This year’s updated estimates show that despite lackluster economic growth and fi...scal cutbacks in many developed countries, total assistance remained steady, reaching an all-time high of $31.3 billion in 2013. While annual increases have leveled off since 2010, continued international funding is a sign of the international development community’s enduring support for global health.
The report also shows shifts in sources of financing. As funding from many bilateral donors and development banks has declined, growth in funding from the GAVI Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, non-governmental organizations, and the UK government is counteracting these cuts. Development assistance for different health issues is tracked up to 2011, revealing that the greatest increase in funding was for maternal, newborn, and child health.
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This document updates the 2014 Core Elements for Hospital Antibiotic Stewardship Programs and incorporates new evidence and lessons learned from experience with the Core Elements. The Core Elements are applicable in all hospitals, regardless of size. There are suggestions specific to small and criti...cal access hospitals in Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals (12).There is no single template for a program to optimize antibiotic prescribing in hospitals. Implementation of antibiotic stewardship programs requires flexibility due to the complexity of medical decision-making surrounding antibiotic use and the variability in the size and types of care among U.S. hospitals. In some sections, CDC has identified priorities for implementation, based on the experiences of successful stewardship programs and published data. The Core Elements are intended to be an adaptable framework that hospitals can use to guide efforts to improve antibiotic prescribing. The assessment tool that accompanies this document can help hospitals identify gaps to address.
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The overall objective of the framework is to support WHO and Members States in meaningful engagement of people living with NCDs, and mental health and neurological conditions to co-create and enhance related policies, programmes and services. This framework will contribute to advancing understanding..., knowledge and action on meaningful engagement and related participatory approaches from an evolving evidence base. It provides practical guidance and actions for transitioning from intention to action to operationalize meaningful engagement.
The aim of the framework is to guide people working at WHO and in Member States in ensuring meaningful engagement with individuals with lived experience. WHO will advocate for, provide technical assistance and operationalize implementation at its three levels (headquarters, regional and country offices) and will support Member States in implementation at national level through established processes and procedures.
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UNICEF CHILD ALERT May 2018
As part of a UNICEF series highlighting the challenges faced by children in current crisis situations, this Child Alert examines the situation of children affected by violent conflict in Kasai region, Democratic Republic of the Congo. The alert outlines what UNICEF a...nd its partners have achieved to date in providing humanitarian assistance to children in Kasai affected by malnutrition and lack of access to health care, safe water and education. It calls upon all parties to the conflict – and the international community – to take urgent action protecting the lives and futures of children at risk, before it is too late.
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Ethiopia GATS was implemented by Ethiopia Public Health Institute (EPHI) in collaboration with the Ethiopian Food, Medicine, Health Care Administration and Control Authority (FMHACA), CSA, FMOH and the World Health Organization (WHO)country office. Technical assistance ...for the implementation of the survey was provided by the WHO, the U.S. Centers for Disease Control and Prevention (CDC), and RTI International. Program support was provided by the CDC Foundation.Financial support for Ethiopia GATS was provided by the CDC Foundation with a grant from the Bill & Melinda Gates Foundation.GATS enhances countries’ capacity to design, implement and evaluate tobacco control programs. It also assistscountries to fulfill their obligations under the WHO FCTC to generate comparable data within and across countries. In addition,it allows countries to implement the WHO MPOWER policy package. WHO MPOWERisa technical packagedevelopedtoassist countries in implementing selected demand reduction measures contained in the WHO Framework Convention on Tobacco Control(FCTC)(5).The six MPOWER evidence-based measures contained in the FCTC;
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The COVID-19 pandemic has been the biggest disaster in living memory, on almost any measure. More than 6.5 million people are confirmed to have died in less than three years, and the pandemic’s indirect impacts have touched the lives of virtually every community on the planet.
Our World Disasters... Report 2022 focuses on the coronavirus pandemic and preparedness: both the ways preparedness ahead of COVID-19 was inadequate, and how the world can prepare more effectively for future public health emergencies.
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The purpose of this document is to present and promote the minimum requirements for IPC programmes at the national and health care facility level, identified by expert consensus according to available evidence and in the context of the WHO core components.
The minimum requirements are defined as: I...PC standards that should be in place at the national and facility level to provide minimum protection and safety to patients, HCWs and visitors, based on the WHO core components for IPC programmes.
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery ...of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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On 25 August, UN agencies and partners launched a US$187.3 million Flash Appeal to reach 500,000 of the most vulnerable people affected by the 14 August earthquake.
Around 650,000 people are in need of emergency humanitarian assistance in the three most affected departments – Grand’Anse, Nipp...es and Sud – where 634,000 were already in need of multisectoral assistance before the quake.
Based on lessons learned from past emergencies, humanitarian actors are aiming to capitalize on local and national level expertise, capacities and knowledge to promote a rapid and effective response tailored to the expressed needs of affected people.
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Monitoring is a crucial element in any successful programme. It is important to
know if health care facilities – and ultimately countries – are meeting the agreed
goals and objectives for preventing and managing cardiovascular diseases (CVD).
Monitoring is the on-going collection, management ...and use of information to
assess whether an activity or programme is proceeding according to plan and/
or achieving defined targets. Not all outcomes of interest can be monitored. Clear
outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met.
To allow progress to be monitored, this module provides a set of indicators on
CVD management. Agreeing on a set of indicators allows countries to compare
progress in CVD management and treatment across different districts or
subnational jurisdictions, as well as at a facility level, identify where performance
can be improved, and track trends in implementation over time. Monitoring
these indicators also helps identify problems that may be encountered so that
implementation efforts can be redirected.
This module starts from the collection of data at facility level, which is then
“transferred up” the system: facility-level data are aggregated at subnational level
to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys.
Implementing a monitoring system requires action at many levels. At national and
subnational levels, staff can determine how best to integrate data elements into
existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS).
In the facility setting, personnel must be aware of what data are needed. Sample
data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools
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HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance implementation of WHO PEN by providing:
• operational guidance on further integrating CVD management
• technical guidance on evaluating the impact of... CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
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This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in health financing. The report points out the need to improve public financial management within th...e health sector, for more efficient financial systems. It focuses on better resourceraising and utilization mechanisms. The matrix highlights the need for consolidation of fragmented health financing arrangements, for a more efficient health system. It also emphasizes the need for enhancing strategic purchasing of health services, to improve the overall efficiency and quality of care. Additionally, the report stresses the critical
role of leveraging data and information systems for more evidence-based informed decision-making. These recommendations are crucial for advancing Kenya’s health financing system and moving closer to the UHC goal.
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